BREAST-CANCER AFTER PREVENTIVE SUBCUTANEO US MAMMECTOMY

Because of a family history of breast cancer, a 51 year old patient un derwent bilateral subcutaneous mammectomy in 1988. In February 1994 sh e presented with a nodule in the supramedial quadrant on the left, Nee dle biopsy suggested galactophoric ade nocarcinoma which was confirmed histologically. A 1.5 cm tumour was removed together with a 3 cm reli quat of glandular tissue. Twelve axillary nodes were dissected and wer e found to be free of neoplasic infiltration. Hormone receptors were p ositive, Post-operative radiotherapy was performed. The outcome is unc hanged at 6 months. Bilateral subcutaneous mammectomy can be proposed as a preventive measure in patients at risk, but as demonstrated by th is case, exeresis is usually incomplete. The level of protection actua lly achieved is thus questionable. Clinicians should be aware of the r isk of breast cancer developing after such elective operations since e arly screening programmes and the development of genetic methods based on the search for BRCA1 and BRCA2 genes will undoubtedly increase the number of patients requesting preventive measures.